[1]鲁　静.血清降钙素原在新生儿败血症病情和预后评估中的应用价值[J].新乡医学院学报,2021,38(12):1171-1174.[doi:10.7683/xxyxyxb.2021.12.013]
　LU Jing.Value of serum procalcitonin in evaluating the condition and prognosis of neonatal sepsis[J].Journal of Xinxiang Medical University,2021,38(12):1171-1174.[doi:10.7683/xxyxyxb.2021.12.013]
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血清降钙素原在新生儿败血症病情和预后评估中的应用价值
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年12
页码:
1171-1174
栏目:
临床研究
出版日期:
2021-12-05

文章信息/Info

Title:
Value of serum procalcitonin in evaluating the condition and prognosis of neonatal sepsis
作者:
鲁　静
（洛阳市妇幼保健院产科,河南　洛阳　471000）
Author(s):
LU Jing
（Department of Obstetrics，Luoyang Maternal and Child Health Hospital，Luoyang 471000，Henan Province，China）
关键词:
败血症; 新生儿; 降钙素原; 预后
Keywords:
septicemia; neonatal; procalcitonin; prognosis
分类号:
R722.13
DOI:
10.7683/xxyxyxb.2021.12.013
文献标志码:
A
摘要:
目的　探讨血清降钙素原（PCT）在新生儿败血症病情和预后评估中的应用价值。 方法　回顾性分析2015年6月至2018年6月洛阳市妇幼保健院收治的268例败血症新生儿的临床资料。依据小儿危重病例评分法评分将患儿分为非危重组（＞80分，n=111）、危重组（71～80分，n=75）和极危重组（≤70分，n=82）；依据脏器功能障碍情况将患儿分为无脏器功能障碍组（n=125）、单一脏器功能障碍组（n=32）和休克或多脏器功能障碍组（n=111）；依据生存情况将患儿分为存活组（n=250）和死亡组（n=18）。采集患儿入院24 h内空腹肘静脉血2 mL，采用免疫发光法测定血清中PCT水平，采用酶联免疫吸附法检测血清中白细胞（WBC）、C反应蛋白（CRP）水平及中性粒细胞占淋巴细胞比值（NLR）。比较各组患儿血清PCT、WBC、CRP水平及NLR，采用受试者工作特征曲线(ROC)分析血清PCT对新生儿败血症病情与生存状况的评估效果。结果　非危重组、危重组和极危重组患儿血清中WBC水平及NLR比较差异无统计学意义（P＞0.05）；极危重组患儿血清PCT和CRP水平高于危重组和非危重组患儿（P＜0.05）；危重组患儿血清PCT和CRP水平高于非危重组患儿（P＜0.05）。 无脏器功能障碍组、单一脏器功能障碍组、休克或多脏器功能障碍组患儿血清WBC水平及NLR比较差异无统计学意义（P＞0.05）；休克或多脏器功能障碍组患儿血清PCT水平高于单一脏器功能障碍组和无脏器功能障碍组患儿（P＜0.05）；单一脏器功能障碍组患儿血清PCT水平高于无脏器功能障碍组（P＜0.05）；单一脏器功能障碍组患儿血清CRP水平高于休克或多脏器功能障碍组和无脏器功能障碍组患儿（P＜0.05）；休克或多脏器功能障碍组患儿血清CRP水平高于无脏器功能障碍组患儿（P＜0.05）。 存活组和死亡组患儿血清WBC、CRP水平及NLR比较差异无统计学意义（P＞0.05）；死亡组患儿血清PCT水平高于存活组患儿（P＜0.05）。PCT预测败血症患儿死亡的界值为75.65 μg·L-1，ROC曲线下面积为0.886，特异度为 90.0％，敏感度为80.0％。结论　血清PCT水平能够有效评估新生儿败血症的病情危重程度和脏器功能障碍情况，并对预后具有较佳的预测价值。
Abstract:
Objective　To explore the value of serum procalcitonin (PCT) in evaluating the condition and prognosis of neonatal sepsis.Methods　The clinical data of 268 neonates with sepsis admitted to Luoyang Maternal and Child Health Hospital from June 2015 to June 2018 were retrospectively analyzed.According to the pediatric critical illness score(PCIS)，the neonates were divided into the non critical group(PCIS>80,n=111),the critical group (PCIS 71-80,n=75) and the extremely critical group(PCIS≤70,n=82);according to the organ dysfunction,the neonates were divided into the non organ dysfunction group (n=125),the single organ dysfunction group (n=32) and the shock or multiple organ dysfunction group (n=111);according to the survival conditions,the neonates were divided into the survival group (n=250) and the death group (n=18).The fasting elbow venous blood(2 mL)was collected within 24 hours after admission.The level of PCT in serum was measured by immunoluminescence method,the levels of white blood cell (WBC),C-reactive protein (CRP) and the ratio of neutrophils to lymphocytes (NLR) were measured by enzyme-linked immunosorbent assay.The serum PCT,WBC,CRP levels and NLR were compared in each group.The effect of serum PCT in evaluating the condition and survival of neonatal sepsis was analyzed by receiver operating characteristic（ROC）.Results　There was no significant difference in serum WBC level and NLR of children among the non critical group,critical group and extremely critical group（P＞0.05）;the serum PCT and CRP levels of children in extremely critical group were higher than those in the non critical group and critical group(P<0.05);the serum PCT and CRP levels of children in the critical group were higher than those in the non critical group(P<0.05).There was no significant difference in serum WBC level and NLR of children among the non organ dysfunction group,single organ dysfunction group,shock or multiple organ dysfunction group (P＞0.05);the serum level of PCT of children in the shock or multiple organ dysfunction group was higher than that in the single organ dysfunction group and non organ dysfunction group (P<0.05);the serum level of PCT of children in the single organ dysfunction group was higher than that in the non organ dysfunction group (P<0.05);the serum level of CRP of children in the single organ dysfunction group was higher than that in the shock or multiple organ dysfunction group and non organ dysfunction group (P<0.05);the serum level of CRP of children in the shock or multiple organ dysfunction group was higher than that in the non organ dysfunction group (P<0.05).There was no significant difference in serum WBC,CRP levels and NLR of children between the survival group and the death group (P＞0.05);the serum level of PCT of children in the death group was higher than that in the survival group(P<0.05).The cut-off value of PCT in predicting death in children with sepsis was 75.65 μg·L-1,the area under the ROC was 0.886,the specificity was 90.0%,and the sensitivity was 80.0%.Conclusion　Serum PCT level can effectively assess the severity of illness and organ dysfunction in children with neonatal sepsis,and has a better predictive value for prognosis.

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更新日期/Last Update: 2021-12-05